Provider Demographics
NPI:1942728100
Name:DEBORAH COLLINS
Entity Type:Organization
Organization Name:DEBORAH COLLINS
Other - Org Name:DEB COLLINS PMHNP-BC LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RXN, PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:720-542-3487
Mailing Address - Street 1:19753 E PIKES PEAK AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7435
Mailing Address - Country:US
Mailing Address - Phone:720-542-3487
Mailing Address - Fax:720-542-3566
Practice Address - Street 1:19753 E PIKES PEAK AVE STE 203
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7435
Practice Address - Country:US
Practice Address - Phone:720-542-3487
Practice Address - Fax:720-542-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81601363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41830539Medicaid